Nature, Nurture, and Hormonal Transition

We are all constantly flowing with a complex mix of hormones. They cycle like tides, they interrelate in fascinating ways, and they are always shifting in response to our physical and social environments. Among these are the “sex steroids,” such as estrogen, progesterone, and testosterone. All of us, whatever our sex, normally produce both the “female” and “male” sex hormones—in fact, calling them “male” or “female” is very odd, considering that a man requires estrogen to produce viable sperm, and a female relies on testosterone for healthy muscle tone. It is the relative balance of estrogen and testosterone—not the absence of one or the other—that determines our secondary sex characteristics, such as the development of breast tissue or facial hair. This balance varies from person to person, because all sex characteristics exist on a spectrum (with some of us living in the middle intersex territory).

We like to tell a simple story in which people have a biological sex, over which is laid social gender (such as the clothing we wear, what we do with the hair on our heads and bodies, or what careers our society deems appropriate for us). Our physical makeup is presented as asocial and unchanging. In fact, we are naturally social beings, born to have our biological makeup affected by our social experiences. For example, humans are born with a capacity for language, but what language we learn depends on the society into which we are born. And the language we learn, in time, affects our brains. Depending on what phonemes are used in the language(s) we learn as children, we become capable of distinguishing some sounds and not others. If we learn a language in which compass-point direction is incorporated when referring to objects, we develop a much stronger innate sense of direction. If we learn to communicate in sign language, the centers of our brain recruited to produce communication develop quite differently. The brain is a “plastic” organ, shaped by social experience.

In my last post I critiqued the argument that having a trans identity should be understood as an intersex disorder of the brain, necessitating genital sex reassignment. I critiqued this argument because (1) I'm intersex and abhor the argument that it is “necessary” to surgically alter our genitals, and (2) the experience of the intersex community cautions that if there were indeed a medical test for some morphology deemed to represent a "trans brain," the result would be eugenic abortion. I got a lot of negative feedback on that post. Interestingly, some people thought it implied an argument against medical transition, which it is most assuredly not my intent (I've transitioned hormonally). My argument was only with the idea that the way to win civil rights is to champion a biological etiology for trans identity. As for etiologies of gender identity or sexual orientation, my take is that I'm sure they're incredibly complex, but also that they are as irrelevant as the etiology of identifying as a "cat person" versus a "dog person," or, less flippantly, the etiology of identifying with a particular religion. Many people affiliate with the religion (or lack thereof) their parents expect them too, but some do not, and either way, their religious identities should be respected, without needing to look for a biological etiology of religious preference to justify respect.

In any case, in this post I'd like to discuss the interrelationship of biology and social factors in hormonal transition.

In my own life, I've lived under four different hormone balances. First, I had the standard prepubertal hormonal milieu of low sex steroids. At puberty, my gonads kicked in and I developed secondary sexual characteristics—and because I had three gonads (two ovaries and an ovotestis), I developed a lot of them. In later adulthood, my internal reproductive organs were removed, and my sex steroid levels soon fell to almost nil (with less testosterone, estrogen or progesterone than what would be expected for a 90-year-old menopausal woman). And several years later I began hormone replacement therapy with testosterone, or “T,” leading to my living with typical male levels of T, unaccompanied by the usual male levels of estrogen or progesterone. I duly note that none of the three hormonal balances I have lived under as an adult are typical ones. What I can report on is what I experienced with a high, estrogen-dominant hormone load, what it's like to live with no sex steroids, and what changed when I went from no sex steroids to T alone.

There is no doubt that hormone replacement therapy has biological effects. When a person takes estrogen, “E,” (sometimes accompanied by progesterone, “P”) to gender transition, she develops breasts, deposits fat around the hips, and develops softer skin and ligaments. When a person undergoes HRT with T to transition, his voice changes, his phalloclitoris enlarges, and he grows more facial and body hair. But we often talk about other changes. In the contemporary U.S., we think of men as aggressive and dominant, and women as empathetic and emotionally labile, and we expect these conditions will develop with HRT. Often, friends and family worry that a trans man will become violent if he undergoes hormonal transition, or that a trans woman will become irrational. It's as if people see testosterone as the Hormone of War, and estrogen as the Hormone of Overwhelming Emotion (helpfully pictured in my little graphic above). In fact, the effects they produce are much less drastic.

Changes that follow HRT are real. But this does not mean that they are only biological, not social. Consider something simple, like voice. A few months after starting HRT, my voice changed. I was very happy about this, as I was never comfortable with my voice. Clearly, T precipitated changes in my vocal cords and larynx. But a lot of the changes in my voice over the course of my transition have been socially produced. First, there's the fact that I consciously chose to “work” at my voice so that I spoke out of a lower part of my register. It's extremely likely that this has affected my physical vocal apparatus, just as a singer's vocal cords are affected by voice training. But many of the changes in my speaking voice were not conscious, while hardly being biological. They emerged from my being perceived as a guy, without my much noticing what was happening.

Consider this: have you ever noticed that you can often guess the gender of the person a guy is speaking to on the phone by how he is talking? Men in the U.S. today tend to speak with a higher pitch and to articulate more clearly when speaking to women, while speaking in a more mumbled, lower range to other guys. “Hi, Mia. Oh, sure, I can meet you at 4 instead. See you then!” vs. “Hey, bro. Uh-huh. Yeah, well. See ya.” So I found myself on the receiving end of bro-talk, and as a result, the way I speak changed. My spouse teases me about my grunted, blasé “uh-huhs.” Social interactions changed the way my voice sounds. You can't tease out the physical sex and social gender effects, because they interact to produce my voice, but they are both there, each influencing the other. And both components are equally “real.”

So: even the embodied changes during HRT that seem physical and simple are both biological and social. The social effects on the more social aspects of our masculinity/femininity are almost certainly more pronounced. Let's consider the idea that men are more aggressive, that this must be biologially caused by T, and thus that HRT with T will make a person more dominant and violent. This belief is shaped by two things: first, by a cultural ideology shared by all patriarchal societies that men's dominance of society is natural, and secondly, by media reports on the phenomenon of “roid rage” in cis men who use T illegally to build muscle mass for sport or body building.

Let me talk about “roid rage” first. This occurs in people who abuse T because they take it in large and irregular doses, causing big hormone spikes. And hormone swings do make people irritable. This is seen, for example, in cis women who experience premenstrual mood swings, because the level of P rises, then falls abruptly before the menstrual period. I can report from my own experience that swings in P level made me much more irritable than changes in T level. Note, however, that we call a woman who is hormonally irritable “bitchy” rather than “raging,” and see her as less threatening. . . In any case, my experience on T has been that since my T level remains fairly constant as I use a moderate and regular dose, I don't “rage” at all. My irritability levels are no higher than they were when I was completely empty of sex steroids, and are much lower than they were under the three-gonad-circus levels I produced naturally before gonadectomy.

What's really interesting, though, is that my behavior has become a lot less dominating and aggressive than it was before my hormonal transition. I used to be very vigorously argumentative. As an academic who was read as a woman, I had to be quite assertive in order to have authority in a classroom or at a conference. It's part of our gender culture that men interrupt women, assuming greater authority in conversation, and engage in the phenomenon of “mansplaining” (i.e., explaining to a woman something she already knows in a patronizing manner). To avoid loss of social prestige as an academic, I was therefore very assertive in conversation, so as not to allow myself to be interrupted or to appear “weak” in the presentation of my ideas to (male) students or colleagues.

After some time on HRT, I found myself taken aback by how I was being perceived. People had become more reserved around me, and somehow more hesitant in conversation. I made a couple of female students cry when critiquing their comments. My behavior had not changed at all—but my social gender had. The level of dominance I'd asserted for many years was now coming across, not as simple authority, but as intimidating. I wonder if some people thought T had made me “mean,” or that I was acting in the gender-stereotyped manner cissexism claims to be characteristic of trans people. In any case, I had to consciously modify my behavior. It took me a while to retrain myself to be more restrained and gentle in my presentation. It was kind of amusing to learn how much more intimidating the assertive comments of a person who is 5'2” would be taken once he was understood as male—but also sad proof of the greater authority granted men in our society. Such is male privilege. . .

So: my take on the idea that T biologically induces rage and dominance is that it is pretty much bullpucky. Big fluctuations in the level of T can cause irritability, as do big swings in the level of E and P, but that's about it.

I don't mean to come across as saying that none of the changes that we associate with temperament and relate to sex hormones have any biological basis. One that I can speak to is crying. For many years, with my high hormone load being dominated by E and P, I cried a lot, and I hated it. The crying stopped when my gonads were removed, and did not resume when I started taking T, to my great relief. And I see that my friends on HRT with E cry much more easily. The thing is, this does not mean I don't get sad or frustrated any less often than I did in the past, or that they used to be emotionally insensitive and now are oversensitive. One of my trans women friends sees being able to cry when upset as one of the greatest gifts of HRT, because people will finally acknowledge the depth of her feelings. I am happy that I don't tear up easily anymore because I have always enjoyed being treated as having an emotional even keel. These relate clearly to gender roles, in which being emotionally expressive is valued in women and devalued in men. Hormones may affect how often we cry, but it's society that gives that great meaning.

Consider this: like crying, hiccups are also related to higher levels of estrogen. I used to get the hiccups a lot; now I don't. However, since hiccups are not burdened by any gender meanings in our society, nobody else has noticed or gives a fig leaf how often I hiccup. Also related to estrogen are more mobile bowels—people with high E suffer from irritable bowel syndrome a lot more than people with low E. A less irritable bowel is another thing I've enjoyed about my T-only hormonal balance that is clearly biologically-induced, but given no social meaning in my transition. The fact that I don't cry much anymore, however, has been remarked upon a lot, and is treated as highly significant.

So, the relationship between nature and nurture in producing “sex difference” is complex. What is clear is that since humans are such profoundly social beings, social forces shape even those things that are usually thought of as “purely biological,” like the effects of sex hormones. It's one of the things that makes understanding humans fascinating.

On Trans Gender Identity and the "Intersex Brain"

Once upon a time, in the fairly recent past, people often asked what made a person gay or lesbian—taking the perspective that homosexuality was a pathology that needed explanation. Various theories were proposed: psychological (could a domineering mother and passive father be the cause?); moral (was it a failure to embrace “traditional Christian family values”?); and biological (was there some hormone imbalance or brain abnormality at fault?).

Today, when someone comes out as lesbian, gay, or bisexual, the question of etiology is rarely raised. Lesbian, gay and bisexual rights advocates are much less likely to spend their time tossing back at the homophobic the questions, “What made you straight? When did you realize you were straight? Could you do something to change your heterosexuality if you tried?” Sexual orientation is generally treated as a fact, something that is not pathological and that requires no etiological explanation.

Back in the 20^th century, however, many advocates for “gay rights” sought to find a physical cause for homosexuality. They hoped that finding proof that there was some immutable, biological reason for homosexuality, beyond the individual's control, would lead to greater social acceptance. In fact, it was political activism, not scientific discoveries, that led to the social shift to viewing LGB people as a minority deserving of protection from bigotry. But for a while, many “gay rights” activists were focused on finding proof that there was such a thing as the “gay brain,” and research on the topic persists today. The size of the hypothalamus of gay men has been argued to be more similar to straight women's than straight men's. It's been posited that straight men and lesbians have brains with a right hemisphere slightly larger than the left, while straight women and gay men have balanced brains.

Implicit behind these arguments is a belief that gay men are in some way effeminate, and lesbians masculine. But LGB activists scoff at this belief today—the idea that gender expression relates to sexual orientation now seems offensive and ridiculous. So while scientific research continues to look for ways in which gay male brains are “feminine” and lesbian brains are “mannish,” LGB rights advocates no longer pay much attention.

We've not come to this point, however, in the struggle for trans gender rights. Trans people today are making strides, but we're now in the position LGB people were decades ago. We face a great deal of discrimination and disgust from the cis gender population, and we are constantly asked, “What made you trans? Was it psychological trauma, is it that you don't respect traditional Christian family values, or is there something wrong with you medically?”

And just like lesbian, gay and bisexual people in the 20^th century, trans people today face such virulent bigotry that many trans people hope finding scientific proof that there is some immutable, physical reason for trans gender identity, beyond the individual's control, will lead to greater social acceptance. Today many trans activists are eager to trumpet neurological studies that purport to show that the brains of trans men are more like the brains of cis men than of cis women, or that the brains of trans women are more like those of cis women than cis men.

It was the philosopher Descartes who first argued that the brain contains localized areas that control the body. He declared that the soul occupied the pineal gland—a theory sounds ridiculous today, when we know that the pineal glad is more prosaically the structure that secretes melatonin. But today, many trans people (it must be clear by now that I am not one of them) are looking for a brain structure housing gender identity. They argue that people are born with a “brain sex,” and that if this “brain sex” differs from the individual's genital sex, they suffer from an intersex condition that must be treated via gender transition.

I am deeply uncomfortable with this intersex theory of gender dysphoria. While I know from personal experience that it gives some trans people great comfort, and while I worry about seeking to demolish what others feel is their life raft, I want to lay out my objections.

My first objection is a scientific one: gender identity and gendered behavior are deeply complex. They are no more located in the hypothalamic unciate nucleus than the soul is located in the pineal gland. If many of ares of the brain are involved in something as comparatively simple as speech, how many more must be involved in matters as complex as sense of self?

A second objection relates to the entire field that Cordelia Fine names “neurosexism.” Basically, the entire field of neurological study of sex differences is pervaded by sexism and flawed by a teleological approach: “We know that men are good at math, logic and sport, while women are good at nurturing and communicating, so let's pin these to some brain differences we can locate.  This will show that politically-correct resistance to the idea of eternal gender roles is pointless.” By linking claims to trans rights to this body of science, we're tying ourselves to gender stereotypes and a regressive social agenda.

A third objection is that the brain is a very “plastic” organ, meaning that it changes over time. For example, when a deaf person communicates via sign language, different areas of the brain are “recruited” to process communication than just those used for oral speech. Furthermore, early and late learners of sign have different patterns of brain activation when they observe another person signing. In other words, the brain, like other parts of the body, is affected by life experience and use--it varies greatly from individual to individual, and for one individual over time. Even if we were to find that trans men resemble cis men in their patterns of brain use, this would not mean that such a similarity is inborn. It would just mean that trans people have life experiences similar to cis people who share their identified sex, cultural norms, and gendered behavior.  This is certainly proof that we experience our gendered identities and lives in the same way cis people do.  It is not proof that trans people are born with intersex brains.

Another objection I have is to the foundational premise at hand: that trans men and cis men are uniformly masculine in their gendered behavior and style, and hence distinct from feminine trans and cis women. In fact, there are plenty of men, cis and trans, who are nurturant parents, or who like the color pink, or who are bad at sports. There are many women, cis and trans, who are dominant athletes, have bad verbal skills, are excellent at spatial relations, or who hate primping. Furthermore, plenty of trans people are nonbinary in identity, which can't be explained in the least by this dyadic, reductionist framework.

I also object as someone who is intersex by birth to the framing of trans identity as an intersex condition. The difficulties faced by intersex people can indeed relate to gender identity, since children born intersex today are forcibly assigned a dyadic sex at birth, and often subjected to sex reassignment surgery to which they cannot consent. If the child grows up not to identify with the sex to which ze was coercively assigned, gender dysphoria results. But no test has ever been developed that can determine what the eventual gender identity of an intersex person will be—not in the brain, the chromosomes, the gonads or the genitals. And the issues intersex people face center on forced sex assignment in childhood--something which advocates of the intersex brain thesis tacitly support when they argue that since trans status arises from an intersex brain, it "must" be treated medically. Like many intersex people, I boggle resentfully at the idea held by some trans people that intersex people are “lucky,” have a privileged relationship to the medical community, or are free from stigma in our lives. The belief that being categorized as intersex would lead to advantages, which causes some trans people to frame trans identity as an intersex condition, is deeply flawed.

Finally, I would argue that this entire issue is a distraction. Remember that it was not the discovery of a brain area “causing” homosexuality that led to the relative successes of the LGB community in gaining civil rights. It was activism that led to those gains. The belief that if differences could be shown to be inborn, liberation would result, seems hopelessly naïve to me. Bear in mind that for many decades, scientists argued that women should not be permitted to vote or attend college because their brains were too small. More starkly, consider the Holocaust, which was founded on a belief in inborn racial inferiority.  Some intersex conditions can be detected prenatally, but this has not led to more widespread acceptance of intersexuality.  When these conditions are detected, doctors typically offer to terminate the pregnancy.

For all these reasons, I urge people not to hitch the wagon of trans rights to the idea of inborn, dyadic, neurological differences. Brains are extraordinarily complex and shaped by culture and experience over time. Gender identities are multiple, gender roles constantly evolving, and gender expression varies widely from individual to individual. Intersex people face huge obstacles, and framing us as the lucky group to be emulated denies our suffering.

The solution to transphobia is not neurology, but political activism.

Trans and Intersex Children: Forced Sex Changes, Chemical Castration, and Self-Determination

Children’s lives lie at the center of social struggles over trans gender and intersex issues. If you talk with trans and intersex adults about the pain they’ve faced, the same issue comes up over and over again, from mirror-image perspectives: that of medical interventions into the sexed body of the child. Intersex and trans adults are often despairing over not having had a say as children over what their sexes should be, and how doctors should intervene. Meanwhile, transphobes and the mainstream backers of intersex “corrective” surgery also focus on medical intervention into children’s bodies. They frame interventions into the sexual characteristics of intersex children as heroic and interventions into the bodies of trans children as horrific.

The terms and claims that get tossed around in these debates are very dramatic. Mutilation. Suicide. Chemical castration. Forced sex changes.

We need to understand what’s going on here, because it’s the central ethical issue around which debates about intersex and trans bodies swirl. The issue here is the question of self-determination, of autonomy. Bodily autonomy is the shared rallying cry of trans and intersex activists, though we might employ it in opposite ways. Refusing it to us is framed as somehow in our best interests by our opponents.

In this post we will look at how four groups frame the issue: intersex people, trans people, the mainstream medical professionals who treat intersex people, and opponents of trans rights.

If you talk to people who were visibly sexvariant at birth, you hear a lot of pain and anger and regret about how their bodies were altered. This is crystallized in the phrase of intersex genital mutilation, or IGM. As a result of infant genital surgery, many intersex people suffer from absent or reduced sexual sensation—something mainstream Western medicine presents as unethical female genital mutilation (FGM) when similar surgeries are performed on girls in other societies. There are further sources of pain: as a result of “corrective” surgeries, intersex people can suffer a wide range of unhappy results, such as loss of potential fertility, lifelong problems with bladder infections, and/or growing up not to identify with the binary sex to which they were assigned. It is extremely painful to identify as female and to know one was born with a vagina that doctors removed with your parents’ consent, or to identify as male and to know one’s penis was amputated. Imagine if someone performed a forced change on you--would you not feel profoundly violated?

So the intersex perspective is that no one should medically intervene in a person’s body without that person’s full informed consent. Bodily autonomy is a fundamental right. Nobody except you can know how you will feel about your bodily form, whether you might want it medically altered, what risks of side-effects you’d consider acceptable. Routine “corrective” surgery performed on intersex infants is thus a great moral wrong.

When you speak with trans people, childhood medical intervention again comes up with an air of great regret, but now the regret is that one was not permitted to access it. Almost every person I’ve ever spoken with who wants to gender transition medically, whether they’re 18 or 75, has expressed the same fear to me: “I’m afraid I’m too old!” For a while this mystified me (how is 22 “old”?), until I realized what they meant was, “I’m post-pubertal.” For many trans people, childhood was awkward but tolerable, as children’s bodies are quite androgynous. Puberty, however, was an appalling experience. Secondary sexual characteristics distorted the body—humiliating breasts or facial hair sprouting, hips or shoulders broadening in ways no later hormone treatments could ever undo. Many trans people live with lifelong despair over how so much maltreatment and dysphoria could have been avoided if they could just have been permitted to avoid that undesired puberty.

So for trans activists, advocating for trans children so that they might avoid this tragedy is vitally important. The child’s autonomy is central, as it is for intersex advocates, but here the issue is getting access to medical treatment in the form of hormone suppressants, rather than fighting medical intervention. What trans activists seek is the right of children to ask for puberty-postponing drugs, to give the children’s families and therapists time to confirm that the children truly identify as trans, and fully understand what a medical transition involves. Then the individual can medically transition to have a body that looks much more similar to that of a cis person than can someone who has developed an unwanted set of secondary sex characteristics.

So for trans and intersex people, children’s autonomy is paramount when it comes to medical interventions into the sexed body. No child should have their sex (e.g. genitals, hormones, reproductive organs) medically altered until they are old enough to fully understand what is involved and actively ask for such intervention. Conversely, once a child is old enough to fully understand what is involved in medical interventions into the sexed body, and requests such intervention, then it should be performed—whether the child is born intersex or not.

This is not yet mainstream medical practice, however. Today, one in every 150 infants faces medical intervention into the sexed body to which they cannot object or consent. Doctors routinely perform such “corrective procedures” on babies with genital “defects” and “malformations.” Meanwhile, few trans-identified children are supported in their identities by families and medical practitioners—and great controversy and resistance swirls around them when it does happen.

So let’s look at the arguments made by mainstream medicine and transphobic activists. How do they counter the cry for autonomy, given that self-determination and freedom are such central ideals in Western societies? What we’ll see is that they employ two opposing claims based in medical ethics: the duty to save a life, and the duty to first do no harm. If we want to protect the rights of trans and intersex children, we have to understand these arguments and be able to counter them.

When intersex advocates try to fight the framing of intersex children’s bodies as “defective” and somehow in need of surgical “correction,” mainstream medicine responds with a claim of medical necessity. In some very rare cases, particular intersex conditions can be associated with actual functional problems such as an imperforate anus, clearly a serious medical problem that necessitates surgery. But the vast majority of medical interventions into intersexed bodies take place without any such functional, physical problem exsting. They are responses to a social issue (discomfort with sex variance) rather than a physical one. What doctors do, however, is reframe social issues into medical ones. “If we don’t do this surgery, this child will be mocked and humiliated—“he” won’t be able to stand to pee, “she” won’t be able to have “normal sex,” “it” will never be able to marry. The child will be a social pariah and thus be at risk for suicide.”

Through this line of argument, altering the body of the sexvariant infant is cast as a noble act that doctors perform out of their duty to save lives. To counter this, what we need to do is point out that actual studies of intersex adults show that while we do have a heightened risk of depression and suicide, these are caused by unhappiness with our medical treatment rather than prevented by it. Loss of sexual sensation, feelings of having been humiliated by doctors, pain from years of “repair” surgery after “repair” surgery, and for those who do not identify with the binary sex to which we were assigned, the vast sense of betrayal that those who were supposed to care for us subjected us to a forced sex change—these are what lead to an increased risk of suicide. What would really help is would be for doctors to follow the precept of “first do no harm,” to perform no procedures upon us without our full informed consent, and meanwhile, to provide intersex children and their families with social support.

Invocations of “primum non nocere,” first do no harm, and of despicable medical impositions on the lives of innocents are also raised by anti-trans advocates. Transphobic activists generally frame all medical transition interventions as mutilations, and this rhetoric rises to fever pitch when the issue of trans children arises. Recently, anti-trans rhetoric has framed the medical provision of puberty-postponing drugs as “chemical castration” (e.g. in this blog post).

“Chemical castration” is an odd concept. First off, if you read any medical article on the topic, you will find it starting by pointing out that the term is a misnomer, as none of the medications used in “chemical castration” destroy the gonads. The term is nevertheless employed due its specific history as a treatment being given by court order to “sexual deviants” to suppress their ability to have sex, where some prior courts had employed actual surgical castration. Today, some jurisdictions use “chemical castration” in cases of pedophilia, but it the past it was a treatment imposed on men convicted of sodomy—that is, to gay men in an era in which gay male sex was criminalized. Transphobic activists use the term “chemical castration” to evoke an aura of adult sexual deviance, in a manner calculated to frame doctors who provide puberty-suppressant drugs as sexually abusing children.

There is a curious twist in this matter of “chemical castration,” in that universally when court-ordered in the past, and often still today, it did not consist of testosterone suppression drugs as you would expect. Instead, injections of estrogen and/or progesterone were (and are) given. In essence, it caused a forced sex change. Thus, for example, when codebreaking British war hero Alan Turing was convicted of homosexuality in 1952 and sentenced to “chemical castration,” he found the unwanted sex changes in his body so horrifying and humiliating that he committed suicide two years into “treatment.”

In the case of trans-identified kids today, the use of the term “chemical castration” is thus a double misnomer. Firstly, no child is castrated—instead, puberty is simply postponed so that if the child, family, and therapist all agree later that a medical transition is appropriate, unwanted secondary sexual characteristics will not have developed. Plenty of adolescents are “late bloomers” by nature; in fact, puberty today occurs many years earlier than it did through most of human history, when human diets lacked sufficient fats and nutrients to support early puberties. So postponing puberty carries no significant dangers. Further, the point of hormone suppression is not to cause a sex change, in contrast to court-ordered “chemical castration treatments.” The point is merely to buy time to ensure that the trans child in question fully understands zir gender identity and the implications of medical transition.

So: we’ve seen a lot of charged language, of claims and counterclaims regarding mutilation versus vital treatment, cruel withholding of medical assistance versus the imposition of sex changes on unconsenting children. How should trans and intersex advocates respond?

What I would do is to point out that strange and conflicting ideas about children’s autonomy and free will are presented by our opponents. When specialists in intersex “corrective” treatments speak to parents or write in medical journals, they urge that genital surgery be performed in infancy, before age two and a half if at all possible. They claim that this way the child will not remember the treatment and will thus adjust well to the altered genitals and/or sex status. (As if medical monitoring and intervention did not often extend throughout the child’s life, and the procedures left no scars and caused no loss of sensation, so the child would “never notice.”) The age of two and a half came out of now largely-discredited ideas of a milestone of “gender constancy” occurring then, based upon notions of the developing brain that directly relate to autonomy. Before age 2.5, it was basically argued, the baby is irrational and lacks agency, and thus thinks magically about bodily sex, including accepting the “crazy” idea that the sex of the body can change. So, in urging very early intervention into intersex bodies today, conventional medicine is urging the total avoidance of the child’s rational thought and agency.

When it comes to treating trans children, on the other hand, instead of rushing things, all sorts of actors want to draw them out. Most doctors and clinics only provide transition services to legal adults. Those few who treat trans children are extremely cautious about providing any medical interventions other than the postponing of puberty.

Both of these approaches deny children autonomy over their bodies and their lives.

What we must urge is that society consistently respect the rights of children. No children should ever be subjected to sexual surgery without their consent. No children should be forced to have cosmetic surgery. But as children mature, they become able to consent to medical treatment that they do actively desire.

How old is “old enough” to agree to medical interventions into the sexed body? That answer depends on the given child—but 2.5 is certainly too young, and 18 is in most cases too old. What I suggest is that when addressing a medical practitioner urging genital surgery on an intersex infant, that we ask, “Would you perform a sex change on a child of this age who was not intersex?” Conversely, when facing transphobic activists saying that no one who is not a legal adult can be old enough to consent to medical transition services, we should ask if our opponent would say the same if the child were intersex. For example, a child with congenital adrenal hyperplasia may be born with a penis externally, and a uterus and ovaries internally. At around age 12 or 13, if there has been no medical intervention, that child can begin to menstruate through the penis, develop breasts, etc. Would the opponent argue that the child could not be old enough to say that he identifies as male and wants to take testosterone (or that she identifies as female and has decided that she wishes to have surgery to feminize her genitalia)? Would the opponent argue an intersex pubescent child should not at least be able to take puberty-postponing medications to avoid unwanted penile menstruation if they and their family and support professionals were still unsure whether to commit to any more permanent intervention?

What we must ask is that society treat intersex and trans-identified children consistently. We all raise our children to learn to make good decisions, so that they can lead good lives. We must nurture children’s autonomy as they grow, understanding that there are some decisions only they can make for themselves. To force a person to live in a sex with which they do not identify is cruelty; to impose unwanted bodily alterations unconscionable. Wishing happiness for our children, we must nurture and then defer to their right to self-determination over interventions into the sexed body.

TSA Body Scanning and the Trans Body

Recently I had an unpleasant experience while travelling: for the first time, I faced TSA screening at the airport with an “Advanced Imaging Technology” body scanner. These are the devices that see through clothing, with the supposed intent of revealing hidden weapons or explosives. While they haven’t yet foiled any terrorist plots, they do lead to a great loss of physical privacy, and for trans people, add a new level of anxiety to air travel. And as my experience illustrates, that anxiety is justified. We are treated as if our bodily differences pose some sort of potential terrorist threat.

I am a trans man. While I am legally male and my ID reflects that, like many trans people I have not had any reconstructive surgery. It is expensive and not covered by my insurance, and while I would like chest surgery, as someone born intersex I am not interested in genital reconstructive surgery. I therefore wear a chest binder and a genital prosthesis. Wearing the binder and genital prosthesis is very important to me. While I’m not in the closet about being trans, I am fortunate in that with my beard and substantial body hair, while wearing the binder and prosthesis my male identity is rarely questioned by strangers, despite my lack of surgery. This gives me the privilege to avoid a lot of harassment that trans people suffer all the time when their trans status is visible to the public.

Traveling while trans is anxiety-producing. Many trans people, especially trans women, have had experience facing harassment from police officers and others in uniforms, and having to be screened by stern-faced uniformed TSA officers isn’t comfortable. Any “discrepancy” in ID is cause for being detained and denied access to one’s flight, and this includes a perceived discrepancy between the gender marker on one’s ID and the TSA agent’s reading of one’s gendered appearance. I’m fortunate enough that no agent has ever questioned the M on my license based on a visual inspection. But body scanners see beneath clothing. . .

I’ve traveled by plane a fair number of times since my legal transition, but always managed to be screened through a standard metal detector before. Though I’ve been concerned about being outed in the process, I’ve never had a problem. In March, however, that luck ran out, and while flying to a conference to present on intersectional identity and intersex issues, I wound up having to go through a body scan. After stepping through, I was told that the scanner revealed "multiple anomalies.” I looked back at the display and saw four markers appearing over the outline of my body: two at the top of my left ear where I have two earrings, and two on my chest, one over each nipple area.

I’d always been most worried about being found to be wearing a genital prosthesis. Other trans men have had problems when outed as wearing them during TSA screening in the past. Complaints about this have in fact helped lead to the one explicit TSA screening policy said to protect trans people: “travelers should neither be asked to nor agree to lift, remove, or raise any article of clothing to reveal a prosthetic and should not be asked to remove it.”

But what the scanner picked up on, besides the fact that I have a couple of earrings, were “chest anomalies.”

I was taken aside for a patdown. I asked that this be done in privacy, and was taken to a room by two TSA (cis) male agents. One blocked the closed and locked door, and the second stood in front of me. They asked me to answer yes or no, did I have any medical implants or a pacemaker, and I said no. I was then given a through full body patdown, which took some time. The agent doing the patdown seemed concerned that I was concealing something under my shirt. I could have explained what the issue was, but the TSA agent, while acting thus far in a detached and professional manner, had not given me any opportunities to speak spontaneously, but just allowed me to answer yes or no to his questions. The question he asked me next was whether I was wearing a back brace. I said no.

The TSA agent then asked me to open my shirt. While I am uncomfortable revealing my chest wearing just my binder, I did so. The two TSA agents then stared at my chest in the binder for a while. The TSA agent doing the patdown finally asked me what my garment was. I said that it was a chest binder, which I wore because I was a trans gender man. The agent said, “A what?” I had to explain what that meant. The agents looked both dubious and uncomfortable.

I was extremely concerned that I was going to be asked to remove the binder, but, after some silent staring and thinking, the TSA agent told me he would screen the garment for explosives with swabs while I was wearing it. While less humiliating for me than being forced to reveal my breasts, the screening for explosives involved having the agent thoroughly rub a series of small swabs over the entire surface of the binder: sides, back and front. This was quite psychologically disturbing for me. The TSA agent’s expression was one of controlled distaste.

After my binder was indeed found not to be a terrorist weapon, I was allowed to leave. The process was not only humiliating, but time consuming, and I had to rush for my plane.

As my experience reveals, it is obvious that the TSA agents need additional training on dealing with trans gender travelers. The TSA agents who screened me were not only completely unfamiliar with what a chest binder is, they had apparently never even heard of trans men. Their standing there staring at me in me with my shirt open to reveal my chest binder while apparently trying to evaluate whether what I said was plausible was very embarrassing to me. The thorough swabbing of my binder involved what was essentially a groping of my chest. Trans people like myself who have not been able to access the reconstructive surgery that we wish are often very private about our bodies. Having to expose my chest triggers dysphoria for me, and I wear my binder even in intimate situations with my spouse.

Some trans organizations have been quite encouraged by the federal policy stating that TSA agents are not to ask travelers to reveal or remove their prosthetics. A group of which I am a member posted the TSA website, including this policy and the link to a complaint procedure for violations of TSA regulations. So I followed the link and filed a complaint. In it I noted that TSA agents such as those who screened me obviously need training in dealing with trans passengers. I wrote “This training must include the fact that the majority of us have not ‘had the surgery,’ because of the high uncovered expense, and that our nonconforming bodily status is something we keep deeply private. The training should spell out the prosthetic devices and garments we may wear, such as penile prosthetics and chest binders for trans men, and breast forms and tucking underwear for trans women. No passenger should be asked to reveal these prosthetic items or garments or to remove them. Furthermore, if a body scanner reveals ‘anomalies’ in the chest or groin areas, TSA agents should be instructed to ask if the passenger is trans gender and is wearing any special undergarments or prosthetics because of that. If the passenger says yes, then the ‘anomaly’ is explained.”

Unfortunately, my complaint led to no results. The official who reviewed it for the TSA Office of Civil Rights and Liberties did not find a violation of policy (I presume because in his view, I was not asked to reveal or remove my genital prosthesis, and a chest binder is not a prosthetic). He viewed the complaint as one not of violation of my civil rights, but as an issue of professionalism, and forwarded my complaint to the TSA Contact Center to be addressed. That office sent me a form letter “response” from a do-not-reply email address. The form letter merely repeated the information posted on the TSA website: that passengers must be screened; that body scanning equipment will detect prosthetics; that if an “anomaly” is revealed, the passenger must accept a pat-down or be refused access to the terminal; and that passengers may request a private pat-down. I wrote back to the Office of Civil Rights asking that I receive an actual response to my request for further TSA training, but never got a reply.

After my experience, I do have some advice for trans travelers. If you wind up in line for a body scanner, be aware that you can ask to skip it and have a pat-down. If you do go through the scanner, if you look back at it you will see a small simplified display with an outline of a body, and colored rectangles over any detected “anomaly,” which will let you know, if you are called aside for further screening, what part of your body they will focus on. You can then, if you wish, pre-emptively state to the agents that you are wearing a binder or breast forms or whatever seems the likely issue. I’d suggest calmly stating that TSA policy forbids requiring a passenger to reveal or remove a prosthesis. You also have the right to request a private screening (although, if the TSA agent seems hostile and you fear mistreatment, a public screening may in fact be safer, even though it involves more public stares).

I’d also suggest that if you are subjected to bodily scrutiny as a trans person that makes you uncomfortable or delays you, that you complain to the TSA Office of Civil Rights and Liberties. I didn’t get a response, but perhaps if you specifically state that you believe your right not to have to reveal or prosthetic was violated, you would. In any case, the more complaints they receive, the more likely it is that eventually something will be done, or at least that someone can document how many complaints have been filed with no result.

For now, anyway, as trans people we have to deal with a system that treats us as potential terrorists because of our bodily differences, which is nonsensical and insulting.

On Sex/Gender Checkboxes

Day in and day out, sex and gender minorities are boxed in by being confronted with sex/gender checkboxes. This starts the moment we are born, when a binary sex must be checked on our birth certificates: “male” or “female.” For individuals who are born with visibly intersex bodies, this requirement causes a crisis. Families and doctors make hasty decisions about which box they'll force us into, and we have to live with the consequences all of our lives. Having checked off a binary “M” or “F,” those with authority over our infant bodies often feel that trying to reshape our bodies conform to the box they've picked is unavoidable. Thus, genital surgeries are routinely performed, despite the deep unhappiness so many intersex people voice about the results as adults. Great pain might be avoided if parents were allowed to acknowledge our physical truth on birth certificates which included an intersex checkbox, or if the gender marker requirement were simply removed.

For people who are trans gender, gender transitioning is made traumatic in large part due to the checkboxes we must face daily. Binary gender markers are everywhere: on our drivers' licenses and passports, on loan applications and job applications, and on websites everywhere (from Facebook to shopping sites to online radio stations). Once you've checked off one box, changing it is bureaucratically and legally difficult—and sometimes there's no way to change it at all. This leads to all sorts of hassles and embarrassment, as we're “outed” in odd contexts. Worse still, if the gender we're living in doesn't match the marker on our ID, we're subject to being banned from flying, arrested by bigoted police officers, and denied employment.

For folks who don't identify with a binary gender, the world of checkboxes constantly denies our very existence. We go institutionally unrecognized, with no way to even try to say “I am here!”

Sex and gender minorities have some protection in institutional settings that bar discrimination on the basis not only of sex, but of gender identity or expression. But often, such policies are adopted with no follow-through on what it really means for a university or company or city to protect gender identity and expression. Unaware of our needs, administrators think only of ensuring that trans people aren't being kicked out just for gender transitioning. While this is certainly important, there are many more needs that must be addressed. And central among these are that sex/gender checkboxes protect the rights of sex and gender minorities.

I have written a Best Practices guide that is under discussion at my university. It lays out a plan for rewriting sex/gender checkboxes that is meant to address the needs of intersex, trans gender, and gender variant people, in this case, in a university setting. There are some inevitable compromises in it between institutional desires for simplicity and brevity, and our desires as individuals to have our identities recognized in all of their fullness and uniqueness. But I wanted to share it here so that other people who are looking for a guideline to use in seeking to better the way institutions around them limit sex/gender choices would have something to start with. It doesn't address the problem of birth certificates, for example, since universities don't issue them. It does, however, address the question of how sex and gender and sexuality should be measured in research in some detail.

Please feel free to share and employ at will.

Best Practices for Identification of Sex/Gender

Compiled by Dr. Cary Gabriel Costello

I. Foundational Principles

Institutions which commit themselves to protecting against discrimination on the basis of sex and of gender identity or expression (GIE) must give individuals the right to self-identify their sex/gender.

Whenever data are gathered about sex/gender, the rights of GIE minorities (intersex individuals, trans men, trans women, and individuals with alternative gender identities) must be protected.

II. Definitions

“GIE minorities” include intersex individuals, trans gender individuals (trans men, trans women, and individuals with alternative gender identities), and people with variant gender expression.

Intersex Persons

While it is common to believe that sex is binary—that is, that all people are born either male or female—in fact, sexual characteristics exist as a spectrum. There is a great deal of variation in chromosomes (XX, XY, XXY, XYY, etc.), hormones (relative levels of estrogen, progesterone and testosterone), secondary sexual characteristics (breasts, hair distribution, etc.) genital configurations, and gonads (ovaries, ovotestes, testes). Intersex people are individuals whose sexual characteristics fall toward the middle of the spectrum. Approximately 1 in 150 people are intersexed according to medical diagnostic criteria. Most are very private about this status, though some are public about it.

Trans Gender Individuals

Individuals whose gender identity does not match the sex they were assigned at birth are deemed trans gender. A trans man was assigned female at birth but identifies as male; a trans woman was assigned male at birth but identifies as female; a genderqueer individual may identify as neither male nor female. Trans gender individuals often transition to their sex of identification, though they may do so in different ways. Some transition socially by changing name, pronoun, and dress. Others also take hormones (testosterone or estrogen/progesterone) to alter their bodies. In addition, some get surgery to change their chests or genitalia. Because surgery is quite expensive, may not be covered by insurance, and because it carries serious risks, many trans gender individuals in the U.S. do not seek or are unable to access surgical transition services.

Variant Gender Expression

People of any sex or gender may have an atypical gender presentation—male femininity, female masculinity, or androgyny.

III. Best Practices in Collecting Data about Sex/Gender

The best practices for collecting data about sex/gender depend on context. If collecting data about sex/gender serves no purpose for the individuals from whom it is collected, then eliminating the question is the best practice. If data are being gathered to protect the rights and well-being of individuals, then individuals should be given self-identification options that allow GIE minorities to self-identify. These options include a shorter form for ordinary uses, and longer forms to be employed in research contexts.

Eliminating Unnecessary Requirements for Individual Sex/Gender Identification

There are many institutional contexts in which people are routinely asked to identify their sex/gender based on common marketing practices or institutional tradition rather than an intent to protect the individuals from discrimination on the basis of their sex/gender. (For example, this is a common requirement in registering to use website services.) In this situation, the best practice is simply to eliminate the unnecessary requirement of declaring sex/gender.

Standard Best Practices Short Form for Sex/Gender Identifications

In contexts in which data is collected order to ensure equal treatment and respect for all, information about sex/gender should be collected in a manner that protects GIE minorities. The goal in implementing sex/gender categories for general data collection is to protect the rights of all people, whatever their physical sex status or gender identity, including intersex individuals, trans men and trans women, and individuals with alternative gender identities. Thus, the inappropriate single question (“Sex: Male__, Female__”) should be replaced with a three-stage approach.

1. Gender identity: Woman __, Man __, Alternate Self-identification (please write in) ______________.
2. Do you have an intersex condition (disorder of sex development)? Yes__, No__.
3. Are you trans gender? Yes__, No__.

In order also to ensure nondiscrimination on the basis of sexual orientation, best practices add a fourth question unrelated to GIE:

4. Sexual orientation: Heterosexual __, Lesbian__,  Gay__, Bisexual__, Queer__, Pansexual__, Asexual__, Alternate Self-identification (please write in) ______________.

AVOID poor practices which undermine individuals' identities instead of protecting them. A common poor practice is to use a single additional checkbox: “Male__, Female__, Transgender___.” This is inappropriate for several reasons. First, it does not allow intersex individuals a way to identify themselves. Secondly, it discriminates against trans men and trans women by framing trans gender identification as incompatible with “real” male or female status. And thirdly, it does not allow for recognition of the distinct needs and identities of individuals who identify as neither male nor female.

Best Practices Long Forms for Research Contexts

Data about sex and gender are often collected in the course of research. If data are to be analyzed along the dimensions of sex and/or gender, two sets of needs must be met. The first relate to the rights of research subjects, who must be protected from harm, including the harm of discrimination on the bases of sex, gender identity or gender expression. In conducting research with human subjects, researchers will inevitably recruit research subjects who are intersex, trans gender, or variant in their gender expression, and are ethically obliged to treat them with respect. The second issue relates to the need of the researcher to have research questions carefully worded in a manner that subjects will understand and respond to in a reliable and valid manner.

Many scientific studies today continue to use “sex” as an independent variable, and measure this in a binary fashion. This is a methodological flaw, as well as discriminating against GIE minorities. It does not allow the researcher to measure what actually accounts for observed variance in the dependent variable: is it physical sex status, internal gender identity, gender-conformity or nonconformity? Just as a study that uses religion as an independent variable is improved when it not only identifies subjects as “Christian,” but allows the subjects to identify a more specific denomination, asks them how religiously observant they consider themselves, and inquires as to how often they attend church, increasing the sophistication of sex/gender questions improves study results. The following measures are suggested:

1. What gender do you identify with? Man__, Woman__, Other (please write in the identity)________________.
2. What sex category were assigned at birth? Male__, Female__.
3. As far as you know, were you born with an intersex or sex variant body? Yes__, No__.
4. Please indicate how masculine or feminine you are in your dress and manner on the following scale: (1) very masculine, (2) moderately masculine, (3) a bit masculine, (4) androgynous, (5) a bit feminine, (6) moderately feminine, (7) very feminine.

In order also to ensure the study is not discriminating on the basis of sexual orientation, and to gather better data, best practices suggest that subjects also be surveyed on their sexual identity. Problems are often raised by the traditional method of asking subjects if they are “heterosexual, homosexual, or bisexual.” For example, people who are gender transitioning or who identify as neither male nor female are often unable to use these sexual orientation categories to classify themselves. Furthermore, it is well established that there is a difference between how many people identify their sexual orientation and the sexual activities in which they actually engage. This may be addressed through questions such as the following:

1. To whom are you attracted, sexually and romantically? (1) only men, (2) mostly men, (3) a bit more toward men than toward women, (4) equally toward men and women, (5) a bit toward women than men, (6) mostly women, (7) only women.
2. With whom have you been sexually involved? (1) only men, (2) mostly men, (3) a bit more men than women, (4) equally men and women, (5) a bit women than men, (6) mostly women, (7) only women.
3. Are the people to whom you are attracted (1) very masculine, (2) moderately masculine, (3) a bit masculine, (4) androgynous, (5) a bit feminine, (6) moderately feminine, (7) very feminine.
4. Consider the idea of a partner who identifies as neither male nor female, but as some other gender such as “genderqueer.” Do you find that (1) very appealing, (2) moderately appealing, (3) a bit appealing, (4) I feel neutral about it, (5) a bit unappealing, (6) moderately unappealing, (7) very unappealing.

Researchers who choose specifically to study GIE minorities should consider them a vulnerable subject pool for IRB human subject protection purposes. In cases of studies recruiting intersex, trans gender, or gender-variant subjects, procedures should be set in place to protect these vulnerable subjects, and the questions asked about sex and gender carefully designed to accord all subjects with full respect for persons. Confidentiality should be strictly protected, data collected in a location where subjects will not be at risk of having others see or overhear their responses, and information sheets listing appropriate support groups and links to mental health resources distributed to those recruited to participate.

Transphobia, Racism, and Segregation

I want to talk about some contemporary issues, and how they relate to American history. The exclusion of trans people from facilities and organizations is not often framed as segregation, but that is exactly what it is, and I want to illustrate that. This will be a rather “heavy” post, but it's important to talk about recurrent patterns in American social history, so that we can learn lessons from our collective past. I'll be discussing patterns and parallels, not equivalences. Racial segregation in the U.S. came into being in the aftermath of racial slavery, the most extreme form of oppression our nation has seen, and one that, as a white man, I cannot claim fully to comprehend. Transphobic segregation does not have this terrible history directly behind it, for which I am grateful. That said, trans people suffer from segregation every day, and to understand the problem, and gain insight into solutions, we have to examine patterns of the justification of segregation across history.

Sometimes, as a trans person, it seems like every day brings another news story about some transphobic incident or initiative. At times there's a ray of light, but often it's followed by a dark cloud of backlash. I have two situations of this sort on my mind right now, both having to do with segregation. These situations illuminate a common thread in American history: the enactment of bigotry through segregation policies that are justified as somehow “protecting the innocent” by oppressing a minority group.

The first of these situations relates to an incident in which a trans woman was shopping at Macy's. When she took some items to a dressing room to try them on, she was denied access by a sales clerk. The customer went to the manager, who told the clerk to let her in to try on her items. The clerk refused, shouting that God doesn't recognize “transgendereds” and that the customer was thus just a man in a dress, about to violate a private women's space. Embarrassed by the scene and by the employee's noncompliance, the manager fired her. The clerk soon acquired a circle of religious advocates demanding her reinstatement, but Macy's actually quietly refused. (See here.)

The day that I read about Macy's asserting a nondiscrimination policy, I was pleasantly surprised. The store would not put up a symbolic “Cis Women Only” sign above the changing room. But, sadly and predictably, a lot of backlash followed. In just one of the actions taken in retaliation, Rep. Richard Floyd, a Tennessee republican, introduced a state measure prohibiting transgender people from using public bathrooms or dressing rooms that conflict with the sex listed on their birth certificates. (Tennessee, by the way, does not permit people to change the sex on their birth certificates when they gender transition.) What uproar this would have led to when bearded Tennessee-born trans men dutifully entered ladies' rooms, one fortunately has only to imagine, as the state sponsor of the bill chose to withdraw it as distracting the legislature from pressing economic issues. While the withdrawal brought me a sigh of relief, I keep hearing the words that Rep. Floyd spoke when introducing the bill:

“I believe if I was standing at a dressing room and my wife or one of my daughters was in the dressing room and a man tried to go in there — I don’t care if he thinks he’s a woman and tries on clothes with them in there — I’d just try to stomp a mudhole in him and then stomp him dry. Don’t ask me to adjust to their perverted way of thinking and put my family at risk. We cannot continue to let these people dominate how society acts and reacts.” (See here.)

Floyd's words follow a time-worn groove in the politics of bigotry in America. A minority group is framed as posing some imaginary threat to privileged innocents, and segregation and violence against that minority are thus framed as justified. The U.S. saw such violent “logic” on a vast scale after the end of the Civil War and the manumission of all who were enslaved. Here are the words of Sen. Benjamin Tillman of South Carolina, speaking on the U.S. Senate floor in March of 1900 in favor of racial segregation and against voting by African Americans: “As to the Negro's 'rights,'— I will not discuss them now. We of the South have never recognized the right of the Negro to govern white men, and we never will. We have never believed him to be equal to the white man, and we will not submit to his gratifying his lust on our wives and daughters without lynching him.” (See here.)

The wave of racist violence against African Americans in the wake of Reconstruction took place on an appalling scale. Between 1889 and 1940, 3800 lynchings of African American men and women were reported—and doubtless, many more went unreported. There was a claim that most of these were in retaliation for black men raping white women in what was termed the “New Crime,” supposedly caused by black men reverting to a “savage type” once the “civilizing influence” of slavery was removed. In fact, as activist and author Ida B. Wells found in her research on 728 lynchings, the majority of lynching victims were not even accused of rape, but of crimes such as “quarreling with Whites” and “incendiarism.”

There is a difference of scale in the level of violence faced by African Americans after Reconstruction and by trans people today. But contemporary transphobic policies and violence follow this historic pattern of blaming the true victim. Rather than owning their bigotry, legislators, street thugs and shop clerks claim that the trans people they exclude or assault “started it.” We don't enter a restroom to use the toilet, they claim: we come in to sexually assault those in the women's room or challenge those in the men's room, so segregating us and/or assaulting us is justified. Any violence against us is framed as merely self-defense, or as defending the honor of women and children. The fact, of course, is that trans people are the victims, and our “offense” is not attacking the “helpless,” but challenging the worldview of an angry, privileged, insecure group.

And so we see our first theme: the projection of violence onto the victims of bigotry.

Justifications for both racial segregation and the segregation of cis and trans people are unfortunately often based on religious worldviews—as the sales clerk justified her actions at Macy's. Many religious organizations are firmly in favor of trans people's rights. But in the U.S., transphobes often present their ideologies as dictated by the Bible. The standard claim of contemporary transphobic Christians is that gender transition violates God's plan:

“Most basic to our understanding оf sex іѕ that God created twо (and оnly two) genders: “male аnd female He created them” (Genesis 1:27). All the modern-day speculation abоut numerous genders—or еven а gender “continuum” wіth unlimited genders—is unbiblical. . . God’s creation оf еаch individual muѕt surely include His designation оf gender/sex. His wonderful work leaves no room for mistakes; nо оnе іѕ born with the 'wrong body'. . . In the Law, transvestism / transvestitism wаѕ specifically forbidden: 'A woman muѕt not wear men’s clothing, nor а man wear women’s clothing, for the Lord your God detests аnyone whо dоes this' (Deuteronomy 22:5). . . Transgenderism іs not genetically based, аnd іt is nоt simply a psychological disorder; it iѕ rebellion аgainѕt God’s plan.” (See here.)

(The fact that sex is indeed a spectrum, which is something that as an intersex person I am aware of every day, raises a problem for this worldview. I once asked an evangelical leader how he could reconcile his claim of divinely-created gender dyadism with my intersex birth status, and the prevalence of intersexuality in all species. He responded that God did not intend for me to be intersex, but that in a world of sin birth defects occurred, and that in the world to come there would be no “errors” like me. . . which conflicts with the simultaneous claim that “His wonderful work leaves no room for mistakes; nо оnе іѕ born with the 'wrong body'.” There is a great illogic in claiming that people born with intersex bodies that bother the majority have defects that must be medically corrected, but nonintersex trans people cannot seek these same medical services because God makes no mistakes.)

Transphobic Christians see in gender transition more than a case of “individual sin;” they see a danger to society as a whole. The entire LGBT community is framed as sexually perverse, polluting society with the belief that sexuality need not be limited to the confines of a marriage between one person who was assigned male at birth and one person who was assigned female. Trans visibility is seen as carrying a further seductive and contagious danger: the idea that both physical sex and gender roles are mutable, which will spread to children and confuse them about their “true” sexes, making them rebellious. In questioning their sexes, they believe, their children will question God's plan as manifested in human bodies since the creation of Adam, and Eve from Adam's rib. Children who question their sex also question Adam's superiority and Eve's submission to him. Thus, trans people threaten the “proper” order of all gender relations in society.

This framing of a persecuted minority as posing a threat to the plan God made manifest in the body also has a long history in the U.S.. Consider this editorial published in a Madison, Wisconsin newspaper, the Daily Argus and Democrat, on September 11, 1857. The editorial advocates in favor of racial segregation, and bases its argument on the idea that segregation will prevent interracial relationships, which are against God's plan:

“Our Creator clearly never intended these two widely dissimilar races to fraternize; if he had wanted them to be one, he would have so made them—but he has placed, with his own finger, a mark , in color, intellect, physiognomy, and other strongly marked characteristics. Whenever these lines of demarkation are endeavored to be obliterated by amalgamation, the white race has been degenerated, enfeebled, and degraded, as a natural consequence.”

Though written a century later, the 1959 order of the trial court in the case of Loving vs. Virginia uses quite similar language. (It would eventually be overturned by the Supreme Court, putting an end to bans on interracial marriage in the U.S.) In sentencing Mildred and Richard Loving to jail under Virgina's Racial Integrity Act of 1924 for having married out of state and returned to Virginia, the trial court wrote: "Almighty God created the races white, black, yellow, malay and red, and he placed them on separate continents. And but for the interference with his arrangement there would be no cause for such marriages. The fact that he separated the races shows that he did not intend for the races to mix."

So we see another recurrent theme: a claim that bigoted civil policies follow God's plan as made clear in the color and shape of the flesh.

I want to examine one more theme—the way that gender and sexuality play out in enforcing marginalization. To do this, I want to turn to another story in the news: that of a 7-year-old Colorado trans girl, whose application to a Girl Scout troop was first denied, then accepted, leading again to lots of backlash. I've already noted that LGBT communities are framed as sexually perverse by bigots. Now, trans people are a gender minority, not a sexual minority. Gender transition does affect sexuality (a person who had been perceived as a straight man is categorized as a lesbian after transitioning, for example), but this is epiphenomenal rather than the cause of gender transition. We gender transition based on our gender identity, not for sexual reasons. Still, gender transgression is so linked in the popular imagination with “homosexuality” that it may seem inevitable that trans people would be viewed by bigots through a sexual lens. But the evocation of sexuality in American bigotry predates LGBT rights movements, and plays out even when sexuality should be deemed a nonissue.

Trans women have been slandered as men costuming themselves as women in order to gain access to women's private spaces to peep upon and sexually assault them by all sorts of groups. Excluding trans women from women's bathrooms, locker rooms, and other “safe spaces” is justified through a familiar Western system of sex/gender ideologies which frames “good women” as fragile sexual victims, to be put on a pedestal in a gilded cage. This same belief system frames even good men as sexual aggressors, able to control themselves around chaste good women, but naturally and excusably provoked by the actions of bad women to take sexual advantage of what is “offered.” Trans women suffer the doubly-negative fate of being framed as sexually aggressive men when in a woman's space, and as bad women who are “asking for it” in a men's space.

But Bobbie Montoya, Girl Scout aspirant, is seven years old. We contemporary Americans should see her as asexual, an innocent child. And yet the rhetoric deployed against her is remarkably unaltered from that directed at adult trans women. First of all, she's trying to enter a girl's space, so she's constantly being framed as a boy. The large majority of news reports blare “Boy Wants to be a Girl Scout,” or something similar. (See, e.g., this.) More importantly, she's framed as posing some sort of ominous threat by transphobic organizations. Three Louisiana Girl Scout troops that disbanded to protest the Colorado troop's action described the admission of trans gender children as not only “extremely confusing” for “normal” children, but as posing a danger to girls. (Here.) In a viral video calling for people to boycott Girl Scout cookies over the trans girl's admission, a 14-year-old Girl Scout says not only that the “radical homosexual agenda” of gender transition can't be permitted and that the trans girl is a boy, but that her presence endangers the other girls' safety. (Here.)

Bobbie Montoya is a button-eyed tot, not even four feet tall, living under extreme scrutiny. She poses no risk to anyone. And yet those fighting against allowing her to desegregate a cis gender Girl Scout troop continually evoke some sexual risk, some nameless dread. What this makes clear is that the justification of segregation as self-defense against a sexual risk has no relation to reality. It is a strategic claim, a trope. The fact that it emerges in the case of trans kids just makes this more obvious.

The gendered nature of the claim of sexual risk means that the bigotry faced by trans people differs a lot by gender. Trans women get the short end of the stick, attacked as victimizers when framed by the prejudiced as men, and sexually victimized when framed as women. Trans men suffer too, but not quite as dramatically. When framed as men, we can be attacked as victimizers, but when framed as women (as we often are by transphobes), though sometimes we are sexually victimized as “bad girls” who are “asking for it,” often we are put in the less physically dangerous (if unpleasant) position of being treated by bigots as pitiful and ugly self-mutilators who must be protected from ourselves.

This pattern of gender differences echoes the dangers faced by African American women and men after Reconstruction. Black men faced a great risk of being physically attacked by racists because they were framed as the most dangerous of male sexual aggressors. White fantasies about black male size and sexual violence were quite potent. For example, one white man who joined a mob of people flocking to look at the body of a lynching victim wrote that “the crowds from here that went over to see [the victim] for themselves said he was so large he could not assault her until he took his knife and cut her, and also had either cut or bit one of her breast off.” (Here.) In fact, stories like these were urban (or rural) legends, fantasies with no relationship to the actual cause of the lynchings, which were usually retaliation against the victim acting in a nondeferent manner, challenging a white man, rather than some accusation of rape. But these violent stories allowed white mobs to feel justified in torturing victims before lynching them, and in mutilating their bodies afterwards.

African American women in the period after the Civil War were the group that actually suffered from an epidemic of transracial rape, in a reality that was an inversion of the myth of the “New Crime.” Evidence of this lies in the marked increase in the proportion of mixed-race children born to African American mothers in the period after the war.

What we see in the case of racial violence after the Civil War is a series of projections, in which a bigoted white majority reversed the positions of victim and attacker. This pattern is echoed by transphobic assaults today in the “trans panic” defense. A cis man who encounters a trans woman and finds her sexually attractive is viewed by bigots as justified in assaulting her for “tricking him” into finding her alluring, her very status as trans woman inviting violence. A cis man who kills a trans woman and claims she initiated a sexual encounter with him, after which he discovered her trans status, routinely walks away with little or no jail time—even if that claim seems patently implausible (see, e.g., this). Conversely, trans men are at risk of becoming victims of “corrective rape” by transphobic straight cis men who find them attractive, their trans status being seen as a provocation, with the chances of prosecution being slim.

It becomes clear when examining the way that gender and sexuality are filtered through bias that those who are the victims of segregation are also the victims of sexual assaults and sexual myths. And yet segregation is justified in the name of protecting the “innocent” majority from a supposedly dangerous, deviant minority group.

What lessons can we draw from the parallels we've seen? In enacting segregationist policies, whether in the case of race or gender identity, there are two bases commonly drawn upon. The first is a claim that the marginalized group represents a sexualized threat to the majority—a claim that is inversely related to actual victimization. The second is a religious claim that God has written an intent that the minority be discriminated against in the flesh—in the color of the skin, or the shape of the body—and that religious order demands enforcement of discriminatory policies. The first claim can be opposed by marshalling the facts to point out empirical reality. The second can be countered by noting both the diversity of religious opinion and the constitutional separation of church and state in America.

The lessons of history show that fighting segregationist policies requires social movements, not just logical arguments. It took many marches and sit-ins and protests to bring about racial desegregation. Furthermore, ending segregation at law doesn't end it in practice. The results of racial desegregation in the U.S. have included the gradual defunding of integrated public transportation, white flight from integrated neighborhoods, and the ongoing de facto segregation of schools by neighborhood. Today, I live in the most racially segregated major metropolitan area in the U.S., so this reality is clear to me. The suburb next door, a former segregated “sundown town,” is now under 2% African American, while African Americans make up about 35% of the total area population. (Map.) So I don't want to come across as implying that ending formal segregation is a sufficient solution to the problem. It isn't. But we live in a time of great flux for the rights of trans people, with nondiscrimination policies and discriminatory policies both being added to the books around the country. I do believe that if advocates for trans people can make clear the continuity between regulations excluding us from facilities and organizations, and the laws that enacted racial segregation in the U.S., it would affect the way some people see us. It's not a panacea, a magical solution, any more than ending legal racial segregation has solved the problem of racial inequality—but it is something worth doing.

So, please, if you have a discussion about discrimination against trans people, use the term “segregation” to refer to our exclusion from schools, public facilities, and organizations. Because segregation is exactly what it is. And point out that the supposed sexual risk posed by integration is a myth—as is abundantly clear in the case of letting a little trans girl into the Girl Scouts. We're not out to “get” cis people. We just want to be able to use the bathroom like anyone else.